No Survival Advantage Displayed With Transarterial Chemoembolization

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Addition of transarterial chemoembolization to sorafenib for treatment of hepatocellular carcinoma (HCC) displayed no survival advantage.
Addition of transarterial chemoembolization to sorafenib for treatment of hepatocellular carcinoma (HCC) displayed no survival advantage.

The addition of transarterial chemoembolization (TACE) to sorafenib for the treatment of hepatocellular carcinoma (HCC) and main portal vein tumor thrombosis (MPVTT) displayed no survival advantage in comparison to sorafenib alone, according to a retrospective analysis published in The Oncologist.

Investigators retrospectively reviewed 183 consecutive patients with advanced HCC and MPVTT, and 89 patients were enrolled within the study. The combination therapy (sorfenib-TACE) and the sorafenib monotherapy groups included 45 and 44 patients, respectively.

Of the patients who received combination therapy, the average number of TACE sessions was 2.6, and the duration of treatment was 5.6 months, vs 5.4 months in the monotherapy group.

Disease control rate was comparable between arms, and median time to progression was 3 months for both and monotherapy arms (95% CI: 2.1-3.8; P=0.924). A significant difference in median overall survival was not detected between combination therapy (7 months, 95% CI: 6.1-7.8) and monotherapy (6 months, 95% CI: 4.7-7.3; P=0.544).

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Sorafenib-specific adverse events were similar between arms, and 21 grade 3/4 adverse events associated with TACE occurred in 12 patients, 2 of which resulted in death.

Due to the morbidity associated with TACE, investigators concluded that sorafenib monotherapy is sufficient for the treatment of advanced HCC and MPVTT.

Reference

  1. Zhang Y, Fan W, Wang Y, et al. Sorafenib with and without transarterial chemoembolization for advanced hepatocellular carcinoma with main portal vein tumor thrombosis: a retrospective analysis. [published online ahead of print October 7, 2015] Oncologist. doi: 10.1634/theoncologist.2015-0196.

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